| Title: |
Nitrous oxide-induced myeloneuropathy:a case series |
| Authors: |
Mair, Devan; Paris, Alvar; Zaloum, Safiya A; White, Laura M; Dodd, Katherine C; Englezou, Christina; Patel, Farhin; Abualnaja, Siraj; Lilleker, James B; Gosal, David; Hayton, Tom; Liang, Di; Allroggen, Holger; Pucci, Mark; Keddie, Stephen; Noyce, Alastair J |
| Source: |
Mair, D, Paris, A, Zaloum, S A, White, L M, Dodd, K C, Englezou, C, Patel, F, Abualnaja, S, Lilleker, J B, Gosal, D, Hayton, T, Liang, D, Allroggen, H, Pucci, M, Keddie, S & Noyce, A J 2023, 'Nitrous oxide-induced myeloneuropathy : a case series', Journal of neurology, neurosurgery, and psychiatry, vol. 94, no. 9, pp. 681-688. https://doi.org/10.1136/jnnp-2023-331131 |
| Publication Year: |
2023 |
| Collection: |
The University of Manchester: Research Explorer - Publications |
| Subject Terms: |
B12 deficiency; clinical neurology; myelopathy; neuropathy |
| Description: |
BACKGROUND: Nitrous oxide (N2O) is the second most common recreational drug used by 16- to 24-year-olds in the UK. Neurological symptoms can occur in some people that use N2O recreationally, but most information comes from small case series. METHODS: We describe 119 patients with N2O-myeloneuropathy seen at NHS teaching hospitals in three of the UK's largest cities: London, Birmingham and Manchester. This work summarises the clinical and investigative findings in the largest case series to date. RESULTS: Paraesthesia was the presenting complaint in 85% of cases, with the lower limbs more commonly affected than the upper limbs. Gait ataxia was common, and bladder and bowel disturbance were frequent additional symptoms. The mid-cervical region of the spinal cord (C3-C5) was most often affected on MRI T2-weighted imaging. The number of N2O canisters consumed per week correlated with methylmalonic acid levels in the blood as a measure of functional B12 deficiency (rho (ρ)=0.44, p=0.04). CONCLUSIONS: Preventable neurological harm from N2O abuse is increasingly seen worldwide. Ease of access to canisters and larger cylinders of N2O has led to an apparent rise in cases of N2O-myeloneuropathy in several areas of the UK. Our results highlight the range of clinical manifestations in a large group of patients to improve awareness of risk, aid early recognition, and promote timely treatment. |
| Document Type: |
article in journal/newspaper |
| Language: |
English |
| ISSN: |
0022-3050; 1468-330X |
| Relation: |
info:eu-repo/semantics/altIdentifier/pmid/37253616; info:eu-repo/semantics/altIdentifier/pissn/0022-3050; info:eu-repo/semantics/altIdentifier/eissn/1468-330X |
| DOI: |
10.1136/jnnp-2023-331131 |
| Availability: |
https://research.manchester.ac.uk/en/publications/53c3d7c6-36e4-45a5-b684-830178c89176; https://doi.org/10.1136/jnnp-2023-331131 |
| Rights: |
info:eu-repo/semantics/openAccess ; http://creativecommons.org/licenses/by-nc/4.0/ |
| Accession Number: |
edsbas.353C7F3C |
| Database: |
BASE |